The occurrence and recognition
of violence in a country is dependant on a number of issues at macro and
micro levels. The epidemiological dimensions are not well known or not
often discussed openly. Many issues involving violence in Sri Lanka are not understood
completely as violence has always been considered a police, legal, personal
or family problem and not as a health problem that needs detailed
epidemiological analysis. This Report on Violence and Health is the first
national report ever published on this important problem. This report
analyses available data to understand violence in the local context and its
impact on the country. It attempts to assess the magnitude of the problem
and describes different aspects of violence in Sri Lanka. This report too
confirms the fact that violence should be considered as multifactorial
in its origin and identifies the ways for the collaboration among different
stakeholders in the prevention of violence. The lead role that the Ministry of Health should take , as the
organization carrying the burden due to morbidity and mortality
attributable to violence is highlighted in the report.

External Review
of the Maternal & Newborn Health Programme

Although Sri Lanka
has made remarkable progress in the last few decades in lowering infant,
child and maternal mortality due to a number of factors, yet wide
disparities in maternal mortality rates exist between geographic regions as
well as population groups. The Infant Mortality Rate (IMR) and Neonatal
Mortality Rate (NNMR) have been stagnant over the past decade. There is
also concern regarding inequitable distribution of services, deficiencies
in quality of care, competing interests for health resources, increasing
costs in health care and constraints faced by the Ministry of Health (MoH). This publication gives in detail the outline of
the external review which was commissioned by the MoH
to examine the MNH components of the current national Maternal and Child
Health (MCH) Programme and to identify achievements, gaps and challenges
faced by the programme, with the recommendations made by the national and
international review team to help in the development of a new strategic
plan for the period 2008- 2012 and beyond.

Sri Lanka Health Atlas

Compared to its neighbouring
countries, Sri Lanka
has achieved much in health. The indicators pertaining to maternal health,
infant health, several communicable diseases such as polio and other
vaccine preventable diseases, and in malaria have shown considerable
improvement. However disaggregated figures show significantly high disease
prevalence in several districts. With more focused interventions, the
disease burden could be reduced in these districts. With a view to
highlight the need for focused interventions in districts, WHO and the
Ministry of Health jointly published the Sri Lanka Health Atlas based on
data available with the ministry for 2001 and 2002.

This publication contains basic health-related
statistics for the 25 administrative districts of Sri Lanka.
The disaggregated data cover the main aspects of health and its
determinants covered under six topics namely: Demography, Economy, Health
Resources, Health Service Utilization, Morbidity, and Mortality.

Throughout the atlas data is represented by horizontal
and vertical bar graphs, line graphs, and maps.

Maternal
Mortality Reduction in Sri
Lanka

As a low income country, Sri Lanka has made significant
progress in reducing maternal mortality compared to other countries
in the developing world. The factors related to the reduction of maternal
mortality are well worth examining as they analyze the success story that
could be used by other countries. These factors also provide the foundation
to further reduce maternal deaths. In spite of the decline in maternal
mortality there is a realization that the majority of deaths are
preventable. The publication examines the reproductive health factors,
socio-economic factors and the service factors that need to be taken into
account to further reduce maternal mortality. The emphasis that needs to be
made in future activities in this regard are well illustrated. It stresses
the fact that there is a need to go beyond the pregnant state and to
introduce an effective programme of pregnancy education and counseling, as
a part of pregnancy preparedness.

Profile of Health
Related NGOs

The Non Governmental Organizations play an important
role in the delivery of Health services at grass root levels. While the
Ministry of Health is responsible in providing the institutional based
health services, through its wide spread net work of curative and
preventive institutions, the Non Governmental Sector too plays an important
role in providing community based health services through hundreds of Non
Governmental organizations.

The coordination through the Non Governmental Sector was
indeed a problem as a comprehensive inventory was not available. This
deficiency was fulfilled with the WHO initiative of publishing the ‘Profile
of Health Related NGO’. This is the only up-to-date inventory of Health
Related NGOs in Sri
Lanka and has assisted health care
providers in coordinating their activities with maximum non governmental
sector collaboration and partnership.

Potential for
Government / NGO Partnership in Health Care

A study of the potential for Government – NGO
partnerships in health care consists of three components.

The first component covers the national policy framework
for NGOs, the political and social context, legal and administrative
framework and the organizational arrangements in the health sector related
to NGOs.

The second component addresses the potential of NGOs as
partners in health care and analyses the strategic areas of coverage,
geographical distribution of the non-governmental sector, professional
capacity, their financial management, strengths and weaknesses.

The third component comprises a directory of NGOs
working in the health sector with information pertaining to their
activities. The information facilitates understand the complex NGO
involvement in health related areas.

Proposal for
Recovery of the Health System of North & East Sri
Lanka

Based on the Health System and Health Needs of the North-East Sri Lanka the efforts made by the
WHO country office to develop an immediate health system recovery plan in
the North and the East is well reflected by this publication. The
publication explicitly highlights the areas of the North East health system
that need urgent recovery. The proposal uses a sector-wide approach to analyze
the needs of the entire health system in the North-East and employs the
logical framework approach to develop the proposal for recovery of the
health system as a whole and provides a clear outline of a short-term plan
to recover the health system in the North-East. This document was
instrumental in seeking a sum of US $ 8.2 million as a grant for the Health
System recovery in the North and the East.

Health System and
Health Needs of the North-East Sri Lanka

The signing of the memorandum of understanding between the
Government of Sri Lanka and the LTTE in February 2002 enabled mutual
halting of all armed hostilities in the conflict affected areas enabling
the provision of health services for those that were battered by the war.
This was followed by the gush of technical and financial assistance
committed by donors for those areas that were affected by the conflict. The
most pressing need during this phase was the lack of adequate health
related data from the North and the East. This publication which was based
on an onsite health situational analysis enabled all development partners
to base their assistance on the true needs of the NorthEastProvince. It describe
the health needs of district health systems in the cleared and un-cleared
areas in the North and East. This document published by the WHO has
assisted the UN country team, Ministry of Health, World Bank and many other
development partners to mobilize funds for the restoration of North East
Health Sector Development.

Macroeconomics
and Health Initiatives – Sri
Lanka

The Millennium Development Goals have set the agenda for
social development in the 21st century. The WHO through its commission on
Macroeconomics and Health has provided a framework for relating
macroeconomic policy and improved health status focusing primarily on the
poor. The publication examines the relationship between macro-economics,
poverty and health, in the context of international and national interest.
The document attempts to provide a critical review on focusing the health
services on the poor and the need to scale up the pro-poor health
interventions. It provides guidance to the health sector regarding the
feasibility of harnessing greater domestic resources and emphasize on the
need for strategic planning of health expenditure in Sri Lanka.

Poverty,
Transition and Health: A Rapid Health System Analysis

As a fulfillment of an request made by the Ministry of
Health the WHO took the initiative of carrying out a rapid appraisal of the
health system in Sri
Lanka, focusing particularly on the
issues of poverty reduction and the challenges of the demographic and
epidemiological transition. The document analyses the present health care
system by identifying the most salient problems of the system:
malnutrition, mal-distribution of resources and structural deficiencies in
health care provision that result simultaneously in under-utilization and
overcrowding at different levels of hospital. The document describes the
performance of the health system and emphasise on
the equity in the health system. It also propose the shift to a new health
delivery model along the lines of development in the public health sphere,
which has shifted its emphasis from damage reduction and risk control to
proactive health promotion.

WHO Country Cooperation
Strategy 2006 – 2011

The WHO Country Cooperation Strategy 2006 – 2011 is a
medium-term strategic framework for cooperation between the Government of
Sri Lanka and WHO, focusing on six strategic areas of intervention which
are consistent with the needs of the country and will support the
Government to adapt and strengthen the health system. Further more the CCS
spells out the principles and core functions of WHO and serves as the
fundamental guiding document for developing all the technical programs of
the organization in the country during this period.

Sri Lanka Tsunami
Response: six months and beyond

In the aftermath of the tsunami, the WHO Country Office
began to collect information on the extent of the disaster and the acute
needs in the affected areas. This publication takes into account the
strategies that were implemented and the responses of these programmes of
work which covered a wide range of health services from ‘strengthening the
management information system’ to ‘disease surveillance and Control’ as
well as the ‘control of vector borne disease’ and ‘water and sanitation’
among other areas. It also illustrates some of the achievements made during
this period.